In late September, Oregon Health & Science University’s president, discussing the changing regulatory scene, seemed particularly passionate about one obscure federal initiative in particular: “The 340B program must not be cut,” Dr. Shereef Elnahal told reporters at the time. “That is an extremely important program for the safety net mission at OHSU has. I know that the pharmaceutical industry feels different about this. There may be some in Congress who feel different about this. It would be disastrous to public health if the 340B program is cut or compromised in any way.”

A few weeks later, Elnahal’s concerns—shared by the Providence health system as well as Oregon’s congressional delegation—have leapt from the Federal Register toward reality.

Backed by the pharmaceutical industry, The

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